Prescription (Wisconsin)

How can I find out if my medication is on the Navitus formulary and is a preferred medication?

To find out if your medication is on the 2018 formulary, you can view and print the formulary from benefits.hshs.org.
Eastern Wisconsin colleagues can also find the 2018 formulary on www.deancare.com/ASO, and Western Wisconsin colleagues will be able to do so beginning January 1, 2018.

To view the Navitus formulary, you will need to log in to and create your account on www.deancare.com/ASO.

Once you click the Navitus logo, you can confirm if your current prescriptions are covered on the Navitus formulary, and at which tier.

If you are a Western Wisconsin colleague, you may find that the drugs included on Navitus’ formulary drug list may be different from your current formulary.

Preferred medications on the formulary will be indicated by an “FB” (brand name) or “FG” (generic).

Non-preferred medications will be indicated by an “NP”.

Medications that are not covered will be indicated by an “NC”.

Note: Contraceptives are only covered by the HSHS Healthy Plan if they are medically necessary for a purpose other than to prevent conception.

If you are a Western Wisconsin colleague and you are taking a medically-necessary contraceptive, you will be able to continue your prescription through March 2018, but your provider will need to submit a request to Navitus to continue this prescription on a medically-necessary basis during this time.

All Wisconsin colleagues can call Navitus Customer Care toll-free at 1-866-333-2757 for information about the formulary or other assistance.

How do I get started with prescription drug mail service through Costco (Navitus)?

You will need to register with Costco by visiting www.pharmacy.costco.com or by calling 1-800-607-6861 before you can fill and manage your mail order prescriptions.

When registering, you should have your Dean Health Plan ID card, and have your doctor prescribe a 90-day prescription plus refills for up to one year (if applicable).

If you have any questions about your pharmacy benefits, call Navitus Customer Care at 1-866-333-2757.

If you are an Eastern Wisconsin colleague, beginning December 1, 2017, you can contact Costco at 1-800-607-6861 with mail order questions or to confirm the transfer of your information.

If you are a Western Wisconsin colleague, you will not be able to see your transferred prescriptions until January 1, 2018.

What are the specialty medications that need to be filled through Lumicera?

Specialty medications are generally prescribed for people with complex or ongoing medical conditions such as multiple sclerosis, hemophilia, hepatitis, and rheumatoid arthritis. These high cost medications typically also have one or more of the following characteristics: injected or infused, but some may be taken by mouth; have unique storage or shipment requirements; require additional education and support from a health care professional; or usually not stocked at retail pharmacies.

Remember that your initial prescription for a specialty drug may be filled at a retail pharmacy. After that, you must use Lumicera or an HSHS pharmacy in order for subsequent refills to be covered. Lumicera can deliver the specialty medication and supplies to your home, doctor’s office or any other location. They also provide access to pharmacists and nurses who can answer your questions about your specialty drugs.

Note: For Western Wisconsin colleagues, most prescriptions for current specialty medications will automatically transfer to Lumicera.

See the 2018 Flexplan Benefits Guide for more details.

What if I don’t use mail service for my maintenance medications?

You may fill your maintenance prescription two times at a retail pharmacy.

After a maintenance prescription is filled twice at a retail pharmacy, you must use mail service for subsequent refills to be covered by the HSHS Healthy Plan's prescription drug coverage.

What is the advantage for using mail service for prescription maintenance drugs?

There are three advantages:

You are very likely to save money on your prescriptions. While the plan options pay the same percentage of the cost, the overall cost is generally lower with mail order because the mail service program can purchase medications in very large quantities. And, there is no dispensing fee included in the cost of mail service prescriptions, while a dispensing fee is included in each 30-day retail prescription.

You have the convenience of home delivery. Medications are delivered directly to your home or another address you specify within 5 days after your order is received, with no charge for standard delivery.

Maintenance medications will not be covered after the third fill at a retail pharmacy. They are covered when filled through the Plan’s mail service pharmacy or an HSHS pharmacy (if there is one located in your area).